Program Letters of Agreements (PLAs) and External Rotation Agreements are defined by the ACGME as, “written documents that address GME responsibilities between an individual accredited program and a site other than the sponsoring institution.” As the sponsoring institution, the University of Florida College of Medicine – Gainesville, FL, has a different governing board than clinical sites, requiring PLAs for accredited program rotations.
All PLAs must have rotation goals and objectives attached using this Rotation Goal and Objective Template.
Read below to select which PLA template to choose. Scroll down for templates.
Please submit all new PLA and RA requests with documentation here
FAQ
I have a three-year program with four rotations [e.g. 1) inpatient pediatrics, 2) outpatient pediatrics and 3) pediatric ICU, 4) community pediatrics]. How many PLAs do I need? What about goals and objectives?
Rotations 1,2, and 3 are all at the same participating site [Participating Site A] while the 4th rotation (community pediatrics) is at Participating Site B. Both participating sites are in the master affiliation list below.
- Two of the rotations [inpatient pediatrics, 2) outpatient pediatrics] have the same local/site director [Dr. X] who is part of University Faculty Pediatric Practice. PRG 1, PRG 2, and PRG 3 all rotate through both rotations.
- The third rotation [3) pediatric ICU] has a different local/site director (Dr. Y) who is part of the University Faculty PICU Practice Group. Only PRG1 and PRG 2 rotate through the PICU.
- The fourth rotation [4) community pediatrics] has a different local/site director (Dr. Z) who is at ABC County Health Department. Only PRG1 and PRG 2 rotate through community pediatrics. This rotation is only with an individual and not a group.
ANSWER: Three PLAs are needed. PLAs need to be by Participating Site, by Site Director and by Rotation. For example:
- PLA 1
- will be at Participating Site A,
- will list the names of two rotations (Inpatient Pediatrics, Outpatient Pediatrics),
- will List Dr. X as the Local/Site Director;
- will list the group University Faculty Pediatric Practice for Supervision and Oversight Responsibilities.
- Two sets of Goals and Objectives will be attached. One set for Inpatient Pediatrics (with different goals and objectives for each level of training: PRG1, PRG2, PRG3) and a second set for Outpatient Pediatrics (with different goals and objectives for each level of training: PRG1, PRG2, PRG3.)
- PLA 2
- will be at Participating Site A,
- will list the name of one rotation (Pediatric ICU),
- will List Dr. Y as the Local/Site Director;
- will list the group University Faculty Pediatric ICU Practice for Supervision and Oversight Responsibilities.
- One set of Goals and Objectives will be attached for Pediatric ICU (with different goals and objectives for each level of training: PRG1, PRG2).
- PLA 3
- will be at Participating Site B (ABC County Health Department),
- will list the name of one rotation (Community Pediatrics),
- will List Dr. Z as the Local/Site Director;
- will list Dr. Z as the educator for Supervision and Oversight Responsibilities.
- One set of Goals and Objectives will be attached for Community Pediatrics (with different goals and objectives for each level of training: PRG1, PRG2).
TEMPLATES
A. UF residents/fellows rotating at sites WITH a Master Affiliation Agreement (PLAs)
**NEW ** 12/23/2022 — There is one template to use for any participating site with which the University of Florida has a master affiliation agreement. If you have UF resident/fellow rotations at the sites with a MAA listed below in Section A, use this MAA PLA template. NOTE: Please be sure to forward both the PLA draft (including goals and objectives) and all email addresses for everyone required to sign the PLA to the GME Office so that the GME Office may route the PLA via DocuSign for signatures.
Participating Sites with a Master Affiliation Agreement:
- Shands Teaching Hospital and Clinics, Inc., UF Health Shands Hospital (Gainesville)
- Shands Teaching Hospital and Clinics, Inc., Shands Jacksonville Medical Center, Inc.
- Department of Veterans Affairs — North Florida/South Florida Veterans Health System
- Central Florida Health, Inc. (UF Health Leesburg Hospital and UF Health The Villages)
- Sacred Heart Health System, Inc. (Ascension Sacred Heart Pensacola)
- Sacred Heart Health System, Inc. (Ascension Sacred Heart Emerald Coast)
- Select Specialty Hospital — Gainesville, LLC
- State of Florida, Department of Health, Lake County Health Department
- State of Florida, Department of Health, Marion County Health Department
- Naval Hospital Florida (Military Treatment Facility)
- Orlando Health, Inc.
B. UF residents/fellows rotating at sites WITHOUT a Master Affiliation Agreement (RAs)
Please use the following templates:
- PLA External Rotation Agreement for One-UF Resident
- PLA External Rotation Agreement for Multiple UF Residents (Note: 10 year contract)
Be sure to request their W9 form to obtain legal name and address.
If the PLA is for an international rotation, please check with the GME office before proceeding.
C. NON-UF residents/fellows experiences/rotations at programs sponsored through the University of Florida College of Medicine – Gainesville, FL: (RAs)
please use the following templates:
- Short Term Rotation Agreement for One External Resident at UF
- Long Term Rotation Agreement for Multiple External Residents at UF (Note: 1 year contract)
Be sure to request their W9 form to obtain legal name and address.
Tips
- Be sure to request their W9 form to obtain legal name and address.
- Legal Entity “Institution” name must be used, see “Section C, Resources” for assistance.
- Non-UF Visiting Residents/Fellows or Courtesy Appointments: please click on the following NI link, log in, and follow the steps on your program’s NI homepage “Onboarding External Rotators”: New Innovations Log In
Resources
Use the links below to assist in completing agreement forms
Look up legal entity of non-governmental institutional names:
Requesting Self Insurance Program (SIP) estimates and payment information for visiting residents/fellows from other institutions:
- Contact: Self Insurance Program Estimate Request
Please note “Estimate Request” in the subject line of the email. The specialty and rotation dates are required for the estimate and also note them in your request. Please enter the estimate amount received in the designated fillable section of the template. - SIP Payments (check or money order, payable to UF Self Insurance Program) should be sent to:
UF JHMHC Self-Insurance Program
Attn: Insurance Services
P.O. Box 112735
Gainesville, FL 32611-2735
For More Information
For any additional questions, please contact Lori Ackley at (352-594-3970) or ackley.lori@ufl.edu or Lynne Meyer at (352-594-6226) or lynnemeyer@ufl.edu.
This page was last updated on January 19, 2023